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Dental - The Unexpected Cost of Long-Term Opioid Use

Long-term opioid use has put a bad taste in the healthcare industry’s mouth – especially those in dental care. From crumbling teeth to dry mouth, long-term opioid use can create a host of dental issues that ultimately impact claim costs and the health of an injured worker.

As we wrap-up our Managing the Pain of the Opioid Epidemic blog series, Leigh Kuhns, national product leader for dental, discusses unexpected consequences of opioid use.  

Dental Issues
One of the most common issues caused by opioids is dry mouth. It’s often the first problem to arise, and here’s why: opioid use inhibits saliva production. This means food particles linger in the mouth, which eventually leads to decay and gum issues. Additionally, as the medication masks the possible pain response from a toothache, an injured worker would not necessarily recognize the severity of the dental issues occurring.

Effect on Claims
In most cases, dental issues are discovered long after the initial claim – months, sometimes even years later. By the time these unexpected issues crop up, they’re often so severe they require long-term or extensive care. For example, teeth removal and dental implants and implant prostheses may be required. This can add a hefty cost to the claim. In many states, payers are required to cover costs that have secondary issues from long-term opioid use.

Prevention is Key

  1. Establish a baseline. When an injured worker begins to experience tooth decay or loss, we are often forced to build a structure without a foundation. Early intervention is the best way to determine if there were pre-existing conditions prior to opioid use. If possible, obtain previous dental records, including examinations and x-rays, early in the claim process.
     
  2. Regular maintenance. Injured workers taking opioids for an extensive period of time need to see a hygienist regularly and receive a fluoride prescription from a dentist. Patients should also receive education on proper oral hygiene.
     
  3. Education. Dental issues are unexpected due to lack of education. Dry mouth sufferers, for example, tend to suck on hard candies or consume sugary drinks to relieve the discomfort. While they may experience some short term relief, they’re actually accelerating the rate of dental disease. Instead, injured workers should rely on over-the-counter products that reduce dry mouth irritation, sugar-free candy and plain water.

By implementing a three-pronged prevention approach – baseline, maintenance and education – you will contain claim costs and help injured workers prevent permanent damage to their pearly whites.

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